Surgical handle assembly

ABSTRACT

The present disclosure includes apparatuses for a surgical handle assembly. An example apparatus includes a reloadable cartridge assembly and a surgical handle assembly including a spring positioned in the surgical handle assembly at a proximal end of a toothed rack. Proximal movement of the toothed rack causes the spring to be compressed and allows for complete opening of the reloadable cartridge assembly.

TECHNICAL FIELD

The present disclosure relates generally to an articulatable surgicalhandle assembly.

BACKGROUND

A surgical handle assembly can be used in a number of surgical devices.One example includes use as a surgical stapler. A surgical stapler is afastening device used to clamp tissue between opposing jaw structures tojoin tissue using surgical fasteners. Surgical staplers can include twoelongated members used to clamp the tissue. One of the elongated memberscan include one or more reloadable cartridges and the other elongatedmember can include an anvil that can be used to form a staple whendriven from the reloadable cartridge. A surgical stapler can receive oneor more reloadable cartridges. An example of reloadable cartridges caninclude having rows of staples having a linear length. For example, arow of staples can have a linear length between 30 mm and 60 mm. Astaple can be ejected by actuation of a movable handle member that is apart of the surgical handle assembly of the surgical stapler.

Some surgical staplers are equipped with an articulation mechanism thatcauses the distal portion of the stapler, the elongated members or jawswhich house a staple cartridge and an anvil for forming the staples, tomove away from or toward the longitudinal axis of the stapler.Articulation is an important feature of a stapler as it allows aphysician or other user of the stapler to properly position the staplerjaws in the proper location and orientation. Some staplers also have afeature that allow a physician to open and close the jaws multiple timesprior to delivering the staples. In some staplers that are equipped withan articulation arm, when the jaws of the stapler are articulated, thedesign of the stapler assembly will not allow the jaws to return to afully open position.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic diagram of an apparatus including a surgicalhandle assembly and a reloadable cartridge assembly in accordance with anumber of embodiments of the present disclosure.

FIG. 2A is a schematic diagram of an apparatus including an articulationassembly and a drive assembly in accordance with a number of embodimentsof the present disclosure.

FIG. 2B is a schematic diagram of an apparatus including an articulationassembly and a drive assembly in accordance with a number of embodimentsof the present disclosure.

FIG. 3 is a schematic diagram of an apparatus including a prior artsurgical handle assembly and a reloadable cartridge assembly inaccordance with a number of embodiments of the present disclosure.

FIG. 4 is a schematic of diagram of an apparatus including a surgicalhandle assembly and a reloadable cartridge assembly in accordance with anumber of embodiments of the present disclosure.

FIG. 5 is a schematic diagram of an apparatus including a surgicalhandle assembly in accordance with a number of embodiments of thepresent disclosure.

DETAILED DESCRIPTION

The present disclosure includes apparatuses for a surgical handleassembly and surgical handles. An example apparatus includes areloadable cartridge assembly and a surgical handle assembly includingan articulation assembly configured to maintain the reloadable cartridgeassembly in various positions. In some surgical handle reloadablecartridge assemblies, the user can articulate the distal end of theassembly by rotating a knob and cam assembly. Rotation of the knob andcam assembly causes an articulation arm to move in a linear direction.

In a number of embodiments, the reloadable cartridge assembly caninclude a first elongated member and a second elongated member that canbe used to clamp tissue. One of the elongated members can house one ormore staple cartridges. The other elongated member can have an anvilthat can be used to form a staple when driven from the staple cartridge.Some reloadable cartridge assemblies have rows of staples. When in useand connected to a surgical handle assembly, a physician may rotate aknob and cam assembly of an articulation assembly. Rotation of the knoband cam assembly causes the articulation arm of the surgical handleassembly to move in a linear direction and, since the handle assembly isconnected to the cartridge assembly, the articulation arm of thecartridge assembly will correspondingly move in a linear direction. Thislinear movement causes the elongated members to move away from or towardthe longitudinal axis of the reloadable cartridge assembly.

Many surgical handle assemblies comprise a toothed rack that interactswith a movable handle and can move proximally and distally. A driveshaft can be connected to a distal end of the toothed rack and, when thereloadable cartridge assembly is attached to the surgical handleassembly, the drive shaft is connected to a blade shaft in thereloadable cartridge assembly. Distal movement of the toothed rack willcause open elongated members to close or clamp. Further distal movementof the toothed rack will cause staples to be delivered. If, at the pointwhen the elongated members have just closed, the toothed rack is movedproximally, the elongated members will reopen or unclamp.

When articulated, the design of some prior art reloadable cartridgeassemblies and/or surgical handle assemblies will not allow theelongated members to fully open during the unclamp process. Embodimentsof this disclosure include surgical handle assembly designs that allowthe elongated members to fully open even when the elongated members arein an articulated position.

In the following detailed description of the present disclosure,reference is made to the accompanying drawings that form a part hereof,and in which is shown by way of illustration how one or more embodimentsof the disclosure may be practiced. These embodiments are described insufficient detail to enable those of ordinary skill in the art topractice the embodiments of this disclosure, and it is to be understoodthat other embodiments may be utilized and that process, electrical, andstructural changes may be made without departing from the scope of thepresent disclosure.

It is to be understood that the terminology used herein is for thepurpose of describing particular embodiments only and is not intended tobe limiting. As used herein, the singular forms “a”, “an”, and “the” caninclude both singular and plural referents, unless the context clearlydictates otherwise. In addition, “a number of”, “at least one”, and “oneor more” can refer to one or more things, whereas a “plurality of” isintended to refer to more than one of such things. Furthermore, thewords “can” and “may” are used throughout this application in apermissive sense (i.e., having the potential to, being able to), not ina mandatory sense (i.e., must). The term “include,” and derivationsthereof, means “including, but not limited to”. The terms “coupled” and“coupling” mean to be directly or indirectly connected physically or foraccess to and movement of the movable handle member, as appropriate tothe context.

The figures herein follow a numbering convention in which the firstdigit or digits correspond to the figure number and the remaining digitsidentify an element or component in the figure. Similar elements orcomponents between different figures may be identified by the use ofsimilar digits. For example, 448 may reference element “48” in FIG. 4,and a similar element may be referenced as 548 in FIG. 5. As will beappreciated, elements shown in the various embodiments herein can beadded, exchanged, and/or eliminated so as to provide a number ofadditional embodiments of the present disclosure. In addition, theproportion and/or the relative scale of the elements provided in thefigures are intended to illustrate certain embodiments of the presentdisclosure and should not be taken in a limiting sense.

FIG. 1 is a schematic diagram of an apparatus 100 including a surgicalhandle assembly 102 and a reloadable cartridge assembly 103 inaccordance with a number of embodiments of the present disclosure. Insome embodiments, the apparatus 100 can be a surgical stapler, forexample.

As shown in the example of FIG. 1, the reloadable cartridge assembly103, e.g. a disposable loading unit, can be releasably secured to adistal end of an elongated body of the surgical handle assembly 102. Inthis example, the reloadable cartridge assembly 103 can include acartridge shaft 111 and a first elongated member 107 and a secondelongated member 109 that can be used to clamp tissue. One of theelongated members can house one or more staple cartridges. The otherelongated member can have an anvil that can be used to form a staplewhen driven from the staple cartridge. As mentioned, an apparatus 100can receive reloadable cartridge assemblies having rows of staples. In anumber of embodiments, third party reloadable cartridge and/orreloadable cartridge assemblies may be used with the surgical handleassembly 102 and embodiments of surgical handle assembly 102 may beconfigured to receive the same.

Handle assembly 102 can include a movable handle 112, radial positioner124, knob and cam assembly 122 and handle shaft 105. The reloadablecartridge assembly 103 can be actuated using knob and cam assembly 122and/or radial positioner 124 to reach a stapling site. Radial positioner124 rotates the reloadable cartridge assembly 103. Knob and cam assembly122 positions the distal end of the reloadable cartridge assembly 103 ata particular angle for stapling. The knob and cam assembly 122 can beconfigured to actuate rotationally and the first elongated member 107and the second elongated member 109 can rotate about an axis of aparticular plane in response to the knob and cam assembly 122 beingactuated rotationally by a user.

FIGS. 2A and 2B are schematic diagrams of an apparatus including anarticulation assembly and a drive assembly in accordance with a numberof embodiments of the present disclosure. With reference to FIG. 1,FIGS. 2A and 2B are views from the bottom of apparatus 100. Alldirectional references for these figures will be with regard to theorientation shown in FIG. 1. The articulation assembly can include aknob and cam assembly 222, a cam connector 232, a handle articulationarm 226, and a reload articulation arm 228. Reload articulation arm 228is connected to jaw pivot assembly 230. When a user rotates knob and camassembly 222 to the left and/or counterclockwise, as illustrated in FIG.2A, it causes cam connector 232 to move in a proximal direction which inturn pulls handle articulation arm 226 and reload articulation arm 228proximally. This causes the elongated members (e.g., elongated members107 and 109 in FIG. 1) to move toward the left and/or counterclockwise.When a user rotates knob and cam assembly 222 to the right and/orclockwise, as illustrated in FIG. 2B, it causes cam connector 232 tomove in a distal direction which in turn pushes the handle articulationarm 226 and the reload articulation arm 228 distally. This causes theelongated members to move toward the right and/or clockwise.

FIGS. 2A and 2B also show a drive mechanism for an apparatus, forexample, a surgical stapler. The drive mechanism can include a toothedrack (e.g., toothed rack 340, 440, and 540 in FIGS. 3, 4, and 5,respectively), a drive shaft 234, and a blade shaft 236. As will beexplained later, movement of a movable handle (e.g., movable handle 112in FIG. 1) can cause distal and proximal movement of the toothed rack.This movement is transferred through drive shaft 234 and blade shaft 236to I-beam 240. Distal movement of the toothed rack can cause theelongated members to close or clamp. Proximal movement of the toothedrack can cause the elongated members to open or unclamp. When in theclamped position, further distal movement of the toothed rack can causestaples to be delivered.

The reload articulation arm 228 can be attached to the jaw pivotassembly 230 on the right side. When the jaw pivot assembly 230 isarticulated toward the side of the reload articulation arm 228, to theright and/or clockwise as illustrated in FIG. 2A, the opening and/orunclamping of the elongated members is impaired as the pulling ofarticulation member 228 compresses a reloadable cartridge unit (e.g.,reloadable cartridge unit 103 in FIG. 1) and the rest of the apparatus.This binding of the apparatus will not allow the elongated members tocompletely unclamp. Prior art apparatuses including surgical staplersmay completely unclamp when in the straight, non-articulated positionand on some occasions when articulated away from the side of the reloadarticulation arm 228. In some embodiments, completely unclamped meansthat the elongated members open to an angle greater than 8 degrees andnot completely unclamped means that the elongated members will only opento an angle of 8 degrees or less.

In some embodiments, the knob and cam assembly 222, the cam connector232, the handle articulation arm 226, the toothed rack, and the driveshaft 234 are located within a surgical handle assembly (e.g., surgicalhandle assembly 102) and the reload articulation arm 228, the bladeshaft 236, and I-beam 240 are located within a reloadable cartridgeassembly (e.g., reloadable cartridge assembly 103 in FIG. 1).

FIG. 3 is a schematic diagram of an apparatus including a prior artsurgical handle assembly 302 and a reloadable cartridge assembly 303 inaccordance with a number of embodiments of the present disclosure. Here,a stop 342 limits the proximal movement of toothed rack 340. It isimportant that the toothed rack 340 and/or the drive shaft (e.g., driveshaft 234 in FIGS. 2A and 2B) are properly positioned so that reloadablecartridges can be connected and/or disconnected. When the toothed rack340 is in its most proximal position and is touching stop 342 theapparatus is in the loading position where reloadable cartridges can beconnected and/or disconnected. Movement of movable handle 312 causesmovement of driving pawl 344 and latch 346. During the clamping andunclamping process, proximal movement of the movable handle 312 causesdriving pawl 344 to move in a distal direction which pushes toothed rack340 in a distal direction. As discussed herein, this distal movementcauses the I-beam (e.g., I-beam 240 in FIG. 2) of the reloadablecartridge assembly 303 to interact with elongated members 307 and 309causing them to close and/or clamp. Distal movement of movable handle312 causes latch 346 to interface with toothed rack 340 and to movetoothed rack 340 in a proximal direction until the toothed rack 340 isat the loading position. This proximal movement of the toothed rack 340causes the I-beam to move proximally allowing elongated members 307 and309 to open and/or unclamp.

When the prior art apparatus of FIG. 3 is articulated, for example,towards a side of a reload articulation arm (e.g., reload articulationarm 228 in FIGS. 2A and 2B), the elongated members 307 and 309 of theprior art apparatus are prevented from completely opening and/orunclamping. For example, the prior art apparatus may only open to angle331. Angle 331 can be 8 degrees or less. For example, the elongatedmembers 307 and 309 can open to an angle 331 of 6 to 8 degrees.

FIG. 4 is a schematic of diagram of an apparatus including a surgicalhandle assembly 402 and a reloadable cartridge assembly 403 inaccordance with a number of embodiments of the present disclosure. FIG.4 shows an aspect of the invention and is an instantaneous view of themovable handle 412 being moved distally during an unclamping processwhich causes latch 446 to move the toothed rack 440 in a proximaldirection past a loading position. Additional movement of the bladeshaft (e.g., blade shaft 236 in FIGS. 2A and 2B), drive shaft (e.g.,drive shaft 234 in FIGS. 2A and 2B), and toothed rack 440 in theproximal direction causes the proximal end of toothed rack 440 tocompress spring 443. This overshoot compensates for the play in theapparatus and allows the reload articulation arm (e.g., reloadarticulation arm 228 in FIGS. 2A and 2B) of the reloadable cartridgeassembly 403 to be fully retracted and the elongated members 407 and 409to fully open. This is a momentary position as the strength of thespring 443 will drive the toothed rack 440 distally back to the loadingposition. The spring 443 can have a force of 2 to 7 pounds. In a numberof embodiments, the spring 443 can have a force of 18 Newtons or 4.05pounds. In some examples, the spring 443 can have a force of between 4and 5 pounds.

As illustrated in FIG. 4, the elongated members 407 and 409 may be fullyopen and/or unclamped when the proximal end of the toothed rack 440 isproximal of the loading position. Even when the elongated members 407and 409 are articulated, for example, towards a side of an articulationarm (e.g., reload articulation arm 228 in FIGS. 2A and 2B), theelongated members 407 and 409 can completely open and/or unclamp. Forexample, the apparatus of FIG. 4 may open to angle 435. Angle 435 can begreater than angle 331 in FIG. 3. Angle 435 can be greater than 8degrees. For example, the elongated members 407 and 409 can open to anangle 435 of 13 to 15 degrees.

In a number of embodiments, when positioning the apparatus (e.g.,stapler) for use, either in open surgery or through an instrument suchas a trocar, the clinician may need to rotate and/or articulate theelongated members 407 and 409 to position them properly. As the stapleris used to clamp, staple, and cut tissue, in some instances theclinician may need to clamp and unclamp the elongated members 407 and409 to ensure that they are properly positioned. With some prior artdevices, when the elongated members 407 and 409 are articulated,especially when the reload articulation arm is moved proximally, thestapler will bind up and the elongated members 407 and 409 will not beable to fully open. In this instance, the clinician either puts up withthe non-optimal opening or can move the elongated members 407 and 409 toa non-articulated position to fully open them. With the embodiments ofthis invention, when the clinician attempts to unclamp the elongatedmembers 407 and 409, they will fully reopen allowing for easier and moreaccurate placement. Once the elongated members 407 and 409 are inposition, the clinician will clamp the elongated members 407 and 409 anddeliver the staples. The cutter on the I-beam (e.g., I-beam 240 in FIGS.2A and 2B) will cut the tissue as the staples are being delivered.

FIG. 5 is a schematic diagram of an apparatus including a surgicalhandle assembly 502 in accordance with a number of embodiments of thepresent disclosure. FIG. 5 illustrates the toothed rack 540 in theloading position. Here, a spring 543 is positioned at the proximal endof toothed rack 540. The spring 543 allows the toothed rack 540 to moveproximally past the loading position before the spring 543 returns thetoothed rack 540 to the loading position. After the movable handle 512has been moved proximally and the distal movement of the toothed rack540 causes elongated members (e.g., elongated members 407 and 409 inFIG. 4) to clamp, distal movement of the movable handle 512 can causethe latch 546 to drive the toothed rack 540 proximally. Further movementwill cause the toothed rack 540 to overshoot the loading position. Forexample, a proximal end of the toothed rack 540 will be positionedproximal of the loading position. This overshoot allows for theunloading (or uncompressing) of a reloadable cartridge assembly (e.g.,reloadable cartridge assembly 403 in FIG. 4). By allowing the toothedrack 540, drive shaft (e.g., drive shaft 234 in FIGS. 2A and 2B), andblade shaft (e.g., blade shaft 236 in FIGS. 2A and 2B) to move proximalof the loading position, the I-beam (e.g., I-beam 240 in FIGS. 2A and2B) can be fully retracted from the elongated members, allowing theelongated members to fully open and/or unclamp.

In FIG. 5, spring 543 is shown as a U-spring, although any spring orspongy material can be used as long as the spring mechanism allows forthe proximal overshoot and has enough strength to move the toothed rack540 back to the loading position. For example, a compression coil springcan be used. In a number of embodiments, a stop 548 may be used toproperly position the spring 543. When toothed rack 540 is at rest andthe proximal end of the toothed rack 540 is touching the unloaded or atrest spring 543, the surgical handle assembly 502 is in the loadingposition.

Although the embodiments were described with respect to a specific driveassembly and articulation assembly, the embodiments described herein areequally applicable to other drive mechanisms and articulationmechanisms. As long as the drive assembly and articulation assembly arecomprised of rods or beams that travel in the shafts of the reloadablecartridge assembly and the surgical handle assembly 502, theseembodiments are applicable. Similarly, in FIGS. 2A and 2B a particulararrangement of connecting the blade shaft 236 and reload articulationarm 228 to jaw pivot assembly 230 is shown. The embodiments of thisdisclosure are applicable to other connection arrangements. Regardlessof the connection arrangement, when the reload articulation arm ispulled in a proximal direction and the elongated members are articulatedto the articulation arm side or position, the elongated members will notfully open but can be fully opened if the teachings of this disclosureare followed.

In some of the embodiments described herein, the drive mechanism is themovable handle 512. These embodiments are equally applicable to poweredhandles where an electric motor drives the toothed rack and/or driveassembly. In some embodiments, an electric motor is configured to movethe drive assembly while a movable handle 512 is used to clamp andunclamp the elongated members.

Some of the embodiments described herein have a surgical handle assembly502 with a reloadable cartridge unit. The embodiments herein are equallyapplicable to a staple system where the reloadable cartridge unit isjust a staple cartridge that is loaded into one of the elongatedmembers.

Although specific embodiments have been illustrated and describedherein, those of ordinary skill in the art will appreciate that anarrangement calculated to achieve the same results can be substitutedfor the specific embodiments shown. This disclosure is intended to coveradaptations or variations of one or more embodiments of the presentdisclosure. It is to be understood that the above description has beenmade in an illustrative fashion, and not a restrictive one. Combinationof the above embodiments, and other embodiments not specificallydescribed herein will be apparent to those of skill in the art uponreviewing the above description. The scope of the one or moreembodiments of the present disclosure includes other applications inwhich the above structures and processes are used. Therefore, the scopeof one or more embodiments of the present disclosure should bedetermined with reference to the appended claims, along with the fullrange of equivalents to which such claims are entitled.

In the foregoing Detailed Description, some features are groupedtogether in a single embodiment for the purpose of streamlining thedisclosure. This method of disclosure is not to be interpreted asreflecting an intention that the disclosed embodiments of the presentdisclosure have to use more features than are expressly recited in eachclaim. Rather, as the following claims reflect, inventive subject matterlies in less than all features of a single disclosed embodiment. Thus,the following claims are hereby incorporated into the DetailedDescription, with each claim standing on its own as a separateembodiment.

What is claimed is:
 1. A surgical handle apparatus, comprising: atoothed rack; a movable handle wherein proximal movement of the movablehandle causes distal movement of the toothed rack and distal movement ofthe movable handle causes proximal movement of the toothed rack; and aspring positioned at a proximal end of the toothed rack.
 2. Theapparatus of claim 1 further comprising a driving pawl and a latchconnected to the movable handle, the driving pawl interacting with thetoothed rack to effect distal movement of the toothed rack and the latchinteracting with the toothed rack to effect proximal movement of thetoothed rack.
 3. The apparatus of claim 1 wherein, when the spring is atrest and the proximal end of the toothed rack is touching the spring,the proximal end of the toothed rack is positioned in a loadingposition; and wherein proximal movement of the toothed rack causes theproximal end of the toothed rack to move proximal of the loadingposition and to compress the spring.
 4. The apparatus of claim 3 whereina force of the spring causes the proximal end of the toothed rack tomove distally back to the loading position.
 5. The apparatus of claim 1further comprising an electric motor connected to the toothed rack suchthat the electric motor provides distal and proximal movement of thetoothed rack.
 6. The apparatus of claim 4 wherein the force of thespring is between four and five pounds.
 7. An apparatus, comprising: areloadable cartridge assembly comprising: a blade shaft, an articulationarm, and two opposable elongated members; a surgical handle assemblycomprising an articulation assembly configured to actuate thearticulation arm of the reloadable cartridge assembly from a firstoperation position to a second operation position, a toothed rack, amovable handle configured to acuate the toothed rack, and a springpositioned at a proximal end of the toothed rack; wherein when theproximal end of the toothed rack is touching the spring and the springis at rest the proximal end of the toothed rack is in a loadingposition; and wherein, when the movable handle is moved in a distaldirection and the toothed rack is moved in a proximal direction, themovement of the toothed rack will cause the proximal end of the toothedrack to move past the loading position and to compress the spring. 8.The apparatus of claim 7 wherein proximal movement of the movable handlecauses the blade shaft to move distally which causes the elongatedmembers to close and distal movement of the movable handle causes theblade shaft to move proximally which causes the elongate members toopen.
 9. The apparatus of claim 8 wherein when the toothed rack ispositioned proximal of the loading position, a force of the springcauses the toothed rack to be moved back to the loading position. 10.The apparatus of claim 9 further comprising a jaw pivot assemblyconnected to the elongated members and the articulation arm whereinmovement of the articulation arm causes the elongated members to pivotaway from the longitudinal axis of the reloadable cartridge assembly andwherein the movement of the articulation arm causes the reloadablecartridge assembly to become bound.
 11. The apparatus of claim 10wherein proximal movement of the toothed rack past the loading positioncauses the reloadable cartridge assembly to unbind.
 12. The apparatus ofclaim 9 further comprising a jaw pivot assembly connected to theelongated members and the articulation arm wherein proximal movement ofthe articulation arm causes the elongated members to pivot to the sidethat the articulation arm is connected to the jaw pivot assembly andwherein the proximal movement of the articulation arm causes thereloadable cartridge assembly to become bound.
 13. The apparatus ofclaim 11 wherein the elongate members can fully reopen when thereloadable cartridge assembly is not bound.
 14. An apparatus,comprising: a reloadable cartridge assembly comprising: an articulationarm and two opposable elongated members; a surgical handle assemblycomprising an articulation assembly configured to actuate thearticulation arm of the reloadable cartridge assembly from a firstoperation position to a second operation position, a drive assembly, amotor configured to acuate the drive assembly, a spring positioned at aproximal end of the drive assembly, wherein when a proximal end of thedrive assembly is touching the spring and the spring is at rest thedrive assembly is in the loading position; and wherein, when the motoris activated and the drive assembly is moved in a proximal direction,the movement of the drive assembly will cause the drive assembly to movepast the loading position and to compress the spring.
 15. The apparatusof claim 14 further comprising a jaw pivot assembly connected to theelongated members and the articulation arm wherein movement of thearticulation arm causes the elongated members to pivot away from thelongitudinal axis of the reloadable cartridge assembly and wherein themovement of the articulation arm causes the reloadable cartridgeassembly to become bound.
 16. The apparatus of claim 14 wherein thesurgical handle assembly further comprises a movable handle whereinproximal movement of the movable handle causes the drive assembly tomove distally which causes the elongated members to close and distalmovement of the drive assembly causes a blade shaft to move proximallywhich causes the elongated members to open.
 17. The apparatus of claim16 wherein proximal movement of the drive assembly causes the proximalend of the drive assembly to move proximal of the loading position andto compress the spring.
 18. The apparatus of claim 17 wherein a force ofthe spring causes the drive assembly to be moved distally back to theloading position.
 19. The apparatus of claim 14, wherein the spring is aU-spring.
 20. The apparatus of claim 14, wherein the two opposableelongated members open to an angle of 13 to 15 degrees when the driveassembly is moved past the loading position.